Active NPI
Courtney R Kenyon, PA
- Physician Assistant
- Scottsdale, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 7802
- Practice address
- 13400 E Shea Blvd
Scottsdale, AZ 85259-5499 - Phone
- (480) 301-8000
- NPI assigned
- Dec 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA1803 | NV | |
| Physician Assistant | 363A00000X | 7802 | AZ | Primary |
Addresses
Primary practice location
13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Mailing address
13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone (480) 301-8000
Other practice location 1
10105 Banburry Cross Dr Ste 250
Las Vegas, NV 89144-6648
Phone (702) 360-7600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619412921 | Medicaid | NV |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ckenyon1191158@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000
4880 Wynn Rd
Las Vegas, NV 89103-5406
Phone (702) 871-5005
5701 E Mayo Blvd
Phoenix, AZ 85054-4502
Phone (480) 342-4200
5777 E Mayo Blvd
Phoenix, AZ 85054-4502
5779 E Mayo Blvd
Speciality Building
Phoenix, AZ 85054-4502
Phone (480) 301-8000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.47 of 100
- Quality
- 78.27
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.62
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA1803 | NV | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Arizona | Current | Accepting new patients | |
| Mayo Clinic Arizona | Current | Accepting new patients | |
| Intermountain Medical Holdings Nevada Inc | Interventional Cardiology | Current | Accepting new patients |
Locations
5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800
13400 E Shea Blvd
Scottsdale, AZ 85259
595 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 566-5500
9280 W Sunset Rd
Ste 320
Las Vegas, NV 89148
Phone (702) 534-5464
4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554
10105 Banbury Cross Dr
Ste 250
Las Vegas, NV 89144
Phone (702) 360-7600
1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500
Interoperability endpoints
- ckenyon1191158@ehrdirect.mayoclinicmsg.org
- courtneykenyon@hcpnv.allscriptsdirect.net
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Mayo Clinic Scottsdale
- Multi-Specialty Clinic/Center
- Scottsdale, AZ
- NPI 1558332494
-
dba Intermountain Health
- Internal Medicine Physician
- Henderson, NV
- NPI 1245997279
Interventional Cardiology
-
- Durable Medical Equipment & Medical Supplies
- Phoenix, AZ
- NPI 1699520049
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1619412921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13400 E SHEA BLVD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852595499",
"telephone_number": "480-301-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13400 E SHEA BLVD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852595499",
"telephone_number": "480-301-8000"
}
],
"practiceLocations": [
{
"address_1": "10105 Banburry Cross Dr Ste 250",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891446648",
"country_code": "US",
"telephone_number": "702-360-7600",
"fax_number": "702-363-3814",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KENYON",
"first_name": "COURTNEY",
"middle_name": "R",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-21",
"last_updated": "2022-11-01",
"certification_date": "2022-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NV",
"license": "PA1803",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "7802",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1619412921",
"state": "NV"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ckenyon1191158@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "13400 E Shea Blvd",
"city": "Scottsdale",
"state": "AZ",
"country_code": "US",
"postal_code": "852595499",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.